TY - JOUR
T1 - Factores asociados con la mortalidad hospitalaria en pacientes admitidos en cuidados intensivos en Colombia
AU - Dennis, R. J.
AU - Pérez, A.
AU - Rowan, K.
AU - Londoño, D.
AU - Metcalfe, A.
AU - Gómez, C.
AU - McPherson, K.
N1 - Funding Information:
RESULTADOS: Estuvieron disponibles para ser analizados 3.066 pacientes. El promedio de edad fue de 53 años, el 43% eran mujeres (p < 0,001). La causa más frecuente de ingreso fue no quirúrgica (63,9%), principalmente infarto miocárdi-co (7,1%). La gravedad de la enfermedad, medida por APACHE II y III, fue como promedio de 14,0 (DE, 6,9) y 48,3 (DE, 23,5), respectivamente. En el análisis multivariado, in-dependientemente de la escala utilizada para ajustar por confusión por la gravedad de la enfermedad (APACHE II y III), los factores asociados con muerte hospitalaria fueron la necesidad de ventilación mecánica, la respuesta pupilar a la luz, el proceder del área médica (no quirúrgico) y el ma-nejo por el grupo de UCI antes de la admisión en cuidados intensivos (p < 0,01).
Funding Information:
Los autores quisieran expresar su gratitud a los miembros del comité evaluador: los representantes de la Asociación Co-lombiana de Medicina Crítica y Cuidado Intensivo (Luis E. Cruz, MD, y Victor Neira, MD), del Ministerio de Salud de Colombia (Carlos I Rodríguez, MD), a Carlos Gaviria, MD, y a Francisco Yepes, MD, PhD. Queremos también agradecer a María Ximena Rojas, RN, coordinadora nacional del estudio, a Edgar Celis MD, J. Fabián A. Gil, y Fernando Rivadeneira, MD, de la UECB en la Universidad Javeriana por su apoyo durante el manejo y el análisis de los datos. Finalmente, los autores también agradecen al grupo de directores médicos y de enfermería que participaron en el estudio, por sacar tiem-po de sus ocupadas agendas, para colaborar con los objetivos necesarios y garantizar la calidad de la información.
PY - 2002/3
Y1 - 2002/3
N2 - Objectives: To describe the demographic features, reasons for hospital admission and factors associated with hospital mortality in patients admitted to intensive care in Colombia. Method: A cohort study of patients admitted to intensive care units (ICUs). Of 89 ICUs identified in Colombia, 20 in ten cities were invited to gather information on 200 consecutive patients admitted to each ICU. Results: Three thousand sixty-six patient cases were available for analysis. The mean age was 53 years and 43% were women (men vs. women, p < 0.001). The most frequent cause of admission was medical (63.9%), acute myocardial infarction patients (7.1%) comprising the largest group. Severity of disease measured as APACHE II and III was a mean 14.0 (SD 6.9) and 48.3 (SD 23.5), respectively. Multivariate analysis, independent of adjustment for severity (APACHE II or III), showed that the factors associated with hospital death were the need for mechanical ventilation, pupillary response, transfer from a medical ward, and management by the ICU team prior to admission (p < 0.01). Conclusion: The most common reason for admission to an ICU in Colombia was myocardial infarction. Besides severity of disease, other variables related to medical care in Colombia are associated with hospital mortality, such as invasive ventilation. Although these variables may be artifacts related to disease severity, they are more likely to be related to quality of care.
AB - Objectives: To describe the demographic features, reasons for hospital admission and factors associated with hospital mortality in patients admitted to intensive care in Colombia. Method: A cohort study of patients admitted to intensive care units (ICUs). Of 89 ICUs identified in Colombia, 20 in ten cities were invited to gather information on 200 consecutive patients admitted to each ICU. Results: Three thousand sixty-six patient cases were available for analysis. The mean age was 53 years and 43% were women (men vs. women, p < 0.001). The most frequent cause of admission was medical (63.9%), acute myocardial infarction patients (7.1%) comprising the largest group. Severity of disease measured as APACHE II and III was a mean 14.0 (SD 6.9) and 48.3 (SD 23.5), respectively. Multivariate analysis, independent of adjustment for severity (APACHE II or III), showed that the factors associated with hospital death were the need for mechanical ventilation, pupillary response, transfer from a medical ward, and management by the ICU team prior to admission (p < 0.01). Conclusion: The most common reason for admission to an ICU in Colombia was myocardial infarction. Besides severity of disease, other variables related to medical care in Colombia are associated with hospital mortality, such as invasive ventilation. Although these variables may be artifacts related to disease severity, they are more likely to be related to quality of care.
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U2 - 10.1016/S0300-2896(02)75168-5
DO - 10.1016/S0300-2896(02)75168-5
M3 - Artículo
C2 - 11900688
AN - SCOPUS:0036510806
SN - 0300-2896
VL - 38
SP - 117
EP - 122
JO - Archivos de Bronconeumologia
JF - Archivos de Bronconeumologia
IS - 3
ER -